Dr. Joy Varghese is a hepatologist and liver transplant physician in Chennai, India. He is a director of hepatology and transplant hepatology at Gleneagles Global Health City and a visiting consultant hepatologist at Government Stanley Medical College Hospital. He has played a key role in establishing liver transplant programs across Tamil Nadu and Kerala. He has received several awards for his work, including the Best Doctor Award from the Government of Tamil Nadu.

1. Dr. Joy Varghese
JOY LIVER CARE

2. Doctor’s profile
Dr. Joy Varghese is a Director in Hepatology & Transplant Hepatology, Institute of
Liver Disease & Transplantation, Gleneagles Global Heath City, Perumbakkam,
Chennai. He is a visiting Consultant Hepatologist & Liver Transplant Physician and
member of teaching faculty in Department of Hepatology and Institute of Liver
Transplantation in Govt. Stanley Medical College Hospital, Chennai. He is also an
Adjunct Professor in Department of Medical Gastroenterology –SRM Institute of
Science & Technology, Chennai.
He has played a vital role for setting up cadaver liver transplant programs in various
hospitals across Tamil Nadu and Kerala in the Government & Non-Government
sector. He has recently received the Best Doctor Award 2018 – 2019 – By
Government of Tamil Nadu, and the Medical Excellence Award 2018 –
2019(received from Honourable Governor of Kerala). He has been serving as a
as a respected editor for international journals that include the prestigious "World
Hepatology".

3. List of Notable Awards
1. Einthoven prize in Electro cardiology - First prize out of 70 M.D. postgraduate students and
Association of Physician of India (A.P.I.) Medal in M.D. (Internal Medicine)
2. Levy Thomson Award for clinical research work on “Understanding pathophysiology of hyperventilation
in Cirrhosis” – Received at Canadian Digestive Disease Week, Banff, Canada in 2007.
3.Indo – British “Young Investigator Award” – for clinical research work on “Hyper-Immune plasma in Post
Liver Transplantation” at MIOT hospital, Chennai.
4.Best Doctor Award 2018 – 2019 - By Government of Tamil Nadu.
5. Medical Excellence Award 2018 – 2019 - Received from Honourable Governor of Kerala .

4. KNOW YOUR DISEASE
• How to protect Liver?
• Fatty liver disease
• Hepatitis B&C
• Liver cancer
• Pediatric liver disease
• Liver Transplantation
• Genetic Liver Problems.

5. HOW TO PROTECT LIVER?
What is LIVER?
Liver is the largest organ in our body which performs many important
metabolism of carbohydrate, protein and fat, (b) storing some nutrients,
energy, (d) producing bile - a substance that helps the digestion and
synthesis, (f) helping the blood to clot, and (g) most importantly break
including alcohol, and drugs in the blood.
How to protect our liver?
• Avoid alcohol
• Keep blood sugar & cholesterol under control
• Regular walking or exercise
• Maintain ideal body weight (Height in cm minus 100 = ideal body weight)
Example: If height is 160cm, ideal body weight will be 160 minus 100 = 60; that
is 60kg)
• Get vaccine for Hepatitis B virus irrespective of age if not yet received
• Do screening check-up for liver disease minimum once in 5 years.

6. FATTY LIVER DISEASE
Fatty liver disease is a medical condition that is characterized by the
accumulation of fat (called as steatosis) within the liver (i.e) fat droplets within
hepatocytes.
Risk factors for NAFLD:
• Diabetes mellitus
• Obesity / over weight
• Dyslipidemia (High cholesterol)
• Hypertension (High blood pressure)
• Hypothyroidism (Thyroid disease)
Management:
• Keep sugar / cholesterol level under control
• Maintain ideal body weight (Body mass index – 22 to 24)
• Less carbohydrate diet Eat a healthy diet
• Regular walking

7. HEPATITIS B&C
“Hepatitis” means inflammation of the liver. Whenever the liver is inflamed or damaged, it will
lose its function. Hepatitis B virus is one of virus which will cause of serious liver disease over
the period of time.
Acute Hepatitis B refers to a short-term infection that occurs within the first 6 months after
someone is infected with the virus. It can range in severity from a mild illness with few or no
symptoms to a serious condition requiring hospitalization. Some people, especially adults, are
able to clear, or get rid of, the virus without treatment. People who clear the virus become
immune and cannot get infected with the Hepatitis B virus again.
HEPATITIS B
Hepatitis C virus disease is a curable disease at initial stage. Similar to Hepatitis B
virus, hepatitis C virus is one of the virus which will transmit through blood & blood
products, unsafe sex and contaminated needles/ syringes, etc.
There is no evidence that kissing or hugging, sneezing or coughing, sharing food
/water or through eating utensils/drinking glasses lead to transmission of hepatitis
C virus
Acute versus chronic hepatitis C infection — when people are first infected with
the hepatitis C virus, they develop acute hepatitis which mostly progress to chronic
infection (i.e) virus will persist for more than 6 months.

8. LIVER CANCER
Hepatocellular carcinoma is the fourth common cause of cancer death in the World. It more
common in men than in women. It also becomes more common with increasing age. There
are other types of liver cancer include cholangiocarcinoma, which starts in the cells that line
the bile duct, angiosarcoma (or haemangiosarcoma), which starts in the blood vessels of the
liver, and hepatoblastoma which is very rare and usually affects young children.
Common symptoms:
• Unexplained weight loss, with or without back pain
• Loss of appetite Swelling of your upper abdomen (tummy)
• Feeling sick (Tiredness)
• Jaundice
Diagnosis & Severity assessment:
•Liver function test
•Alfa-feto protein
•CT abdomen with triphasic study / Whole body PET scan
•Gastroscopy
•HBsAg & Anti HCV
Management: Curative: Resection or Liver Transplantation

9. PEDIATRIC LIVER DISEASE
Biliary atresia
Normally, bile produced from the liver will drain into the intestine (duodenum) through the bile duct. Absence of the bile duct
(i.e) developmental abnormality at birth itself is known as Biliary atresia. Hence, child will have persistence, progressive
jaundice from 2nd week of birth onwards.
Symptoms:
• Jaundice
• Pale coloured stool
• Failure to thrive
• Abdomen distension due to ascites (late stage)
What is jaundice?
Jaundice (yellowish discolouration of eyes / skin) is one of symptom of the liver disease or damage. Most of the liver diseases will cause
jaundice. But sometimes, liver disease might occur and progress even without jaundice.

10. LIVER TRANSPLANTATION
Now a days, liver transplantation is the most successful surgery (>90% survival) for medical therapy
failed liver disease patients.
Indications for liver transplantation:
End Stage Liver Disease (ESLD) due to
1. Viral Hepatitis (HBV & HCV)
2. Alcoholic Liver Disease
3. NASH (Nonalcoholic steatohepatitis)
4. Cholestatic Liver Disease (Biliary atresia, PBC)
5. Metabolic Liver Disease (Ex: Wilson)
6. Autoimmune Liver Disease
7. Vascular Disease (BCS)
•Malignant Diseases of the liver – Hepatocellular carcinoma
•Acute Liver Failure (Infection, Toxin, Idiopathic)
Types of liver transplantation:
1.Deceased donor liver transplantation (DDLT)
2.Living donor liver transplantation (LDLT)
3.Split liver transplantation
4.Auxillary liver transplantation
5.Domino liver transplantation
6.Combined liver & kidney transplantation
7.Segmental liver transplantation
8.Swap liver transplantation

11. GENETIC LIVER PROBLEMS

12. THANK YOU